chapter  9
13 Pages

Substituted or supported decisions?

Examining models of decision-making within interprofessional team decision-making for individuals at risk of lacking decision-making capacity
ByGemma Clarke, Sarah Galbraith, Jeremy Woodward, Anthony Holland, Stephen Barclay

Decisions about artificial nutrition and hydration are often challenging. They might involve issues of life and death: weighing the potential for increased morbidity and prolonged suffering with the potential of a shortened life if no intervention takes place. Competing human rights have to be measured and balanced, such as the right to life and the right to freedom from degrading treatment. The Mental Capacity Act provides a statutory framework within one jurisdiction, England and Wales, for how to proceed when people are judged not to have the mental capacity to make a particular decision. This study examines differing models of supported and substituted decision-making within interprofessional team ethical decisions. It utilises a thematic analysis and draws upon the findings from a previous study examining decision-making in a UK hospital-based interprofessional team concerning patients with complex feeding difficulties.